HMO and PPO plans are two of the most common choices for those who invest in Medicare Advantage coverage.

HMO

  • Must have a primary doctor designated
  • Coverage restricted to in-network healthcare providers
  • Some treatments or services may be limited
  • Referral needed to visit a specialist
  • Often includes prescription drug coverage

PPO

  • Choose your provider
  • Some out-of-network care is covered
  • Can see a specialist without a referral
  • Includes prescription drug coverage

Who Qualifies

  • You must live in a qualified coverage area
  • You must have Medicare Parts A and B
  • You cannot have end-stage renal disease
  • You cannot be covered by a Medigap plan

How It Works

The benefits and costs of a Medicare Advantage plan varies depends on the kind of plan you choose for yourself. The private insurance companies that offer Medicare Advantage are paid a specific a fixed amount by Medicare, and that dictates how those companies interact with you. Your out-of-pocket costs and coverage can vary depending on your choices, and the rules may change every year, so make sure you speak with your insurance company for a complete understanding of your benefits and limitations.

Is Medicare Part C the right choice for you? The team at MedicareGov Directory in St. Louis is here to help you decide. Contact us today to learn more about the Medicare Advantage plans we can offer you through our partners, and start comparing rates today with our online tool!